Medication adherence and role of psychiatric nurse

Abstract

Pharmacotherapy is the most common strategy used for restoring health. Taking treatment has a positive outcome on the illness but in between treatment and outcome, an important role is played by adherence. A systematic review and meta-analysis found the prevalence of nonadherence ranges from 7% to 83%. Nonadherence can be of different types such as primary nonadherence where medication was prescribed but never initiated by the patient; secondary nonadherence where the medication is not taken as prescribed and nonpersistent; and nonadherence where the medication is stopped without the physician's order after starting. Poor socioeconomic status, low level of education, long distance, cost of medication, cultural belief, poor patient–provider relationship, overburden of health-care provider, chronic disease condition, asymptomatic condition, complex medical regimen, long duration treatment, misunderstanding of treatment instruction, medication side effect, and forgetfulness are the most common factors affecting adherence. Although there are no gold standards for assessing adherence, some subjective methods, for example, patient-kept diaries, interviews, and objective methods such as determining the presence of drugs in a patient's body fluid and the use of electronic monitoring can be taken into consideration. Nurses are playing an important role in guiding the patient and their family members regarding different ways to be adherent to medication by providing psychoeducation, motivational interview, different behavioral therapies, compliance therapy, and cognitive behavioral therapies. They should be nonjudgmental and address specific issues during discharge counseling of patients and families for better adherence.